| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,896 |
4,894 |
$758K |
| H2020 |
Therapeutic behavioral services, per diem |
8,303 |
4,213 |
$536K |
| D0999 |
Unspecified diagnostic procedure, by report |
7,949 |
3,126 |
$410K |
| D7140 |
Extraction, erupted tooth or exposed root |
871 |
233 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
1,376 |
443 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,125 |
791 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
869 |
256 |
$306.24 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,523 |
4,553 |
$188.32 |
| D0230 |
Intraoral - periapical each additional radiographic image |
21 |
13 |
$40.72 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
567 |
276 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
679 |
148 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,171 |
791 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
49 |
36 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
131 |
70 |
$0.00 |
| H0039 |
Assertive community treatment, face-to-face, per 15 minutes |
31 |
29 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
30 |
26 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
92 |
41 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
738 |
358 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,599 |
1,562 |
$0.00 |
| D1110 |
Prophylaxis - adult |
113 |
79 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
25 |
14 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
550 |
243 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,064 |
738 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
205 |
143 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
82 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
190 |
153 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
82 |
12 |
$0.00 |
| H0036 |
Community psychiatric supportive treatment, face-to-face, per 15 minutes |
46 |
40 |
$0.00 |